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tv   Book TV  CSPAN  March 13, 2011 10:00pm-12:00am EDT

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industries and the vast paraphernalia that allows the book to come into place, the bookstore, the actual product, the printer, the business about making, the marketing, et cetera, she said in the end, a book is an amazing instrument by which one author sitting alone in the room contact one reader sitting alone in a room. in that comment resonated with me very deeply because i thought to myself, if you forget for a second the vast paraphernalia of evidence, the cat scan, the mris, the billion dollars devices, the wonderful crown jewels of medicine in this country and others, in the end, the medicine is a mechanism by which one person sitting alone in the room can talk to another person. one doctor said he alone can talk to one patient. in that analogy was very deep
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for me because it reminded me about what was essential and what was nonessential. and the essential piece of it was that much like a book, medicine is about storytelling. the dissent begins with the most shamanic at, if you take away all its paraphernalia, it begins with someone saying tell me your story. what happened? that is the first thing that happens when you meet it up your is that you begin to unpack the story. and if they make a claim in the book, doctors then tell a story back to you. and it's an ancient interchange, one of the most ancient interchange is we have is human beings. that itself, that process in itself begins the unpacking or unburdening long before you receive the first dose of whatever medicine you will or will not receive. it is the unburdening of the
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story that is the first. and if you forget that, it seems to be something very important will stop happening. and what's i come to that realization inspired by this comment, it began to become very clear how one could write this book, and remembering there was a vast history here, that it could be written through the eyes of patients. it could be written by telling stories. and if i could tell stories that begin at whatever point in time for a thousand years ago, if i could fulfill stories and flesh out these stories, then what seemed like an insurmountable problem, which is how does one tell this history, would become actually solvable, which is tell the history by moving from story to story to story, typically focusing on those who are right they are, those who experienced the most directly benefit
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patients. now again, that was the solution in principle of the problem, but then that raises a second question which is how does one find these missing stories? how does one uncover the story of a woman who asked. in the name team 50s breast cancer. i recount a moment in time in 1950 in fact when a woman, sandy rosenau calls that they are times and says, i'd like to place an advertisement for survivors of breast cancer. and the society editor gets on the phone and says we can't print the words breast cancer in "the new york times." what if we said we were a survivors group of women with diseases at the chest world. this is 1950. in "the new york times" came to write my book, i said make sure you print that because it's a reminder for all of us that we need to be humble about what we cannot and can be achieved here.
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so this is the background, these stories, the words that can't be uttered, the words that can be whispered in the big sea. the question was, what were the stories? and one thread that came very early on is that i knew somewhere in the story would have to be the story of one of the most remarkable women in recent intellectual history and that is very lasker, near loughborough among many other things directed her philanthropic energies. she was unusual woman for a time, an entrepreneur, a person who then directed an enormous amount of philanthropic energy toward solving, as she put it, transforming the geography and the landscape and if there is one sort of central characters spinning to the story it would be very lasker.
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and it very quickly -- i found sidney farber who begins the book, a scientific collaborator. and it's very lasker gave political legitimacy, she provided the scientific legitimacy for the war on cancer. the book begins with sidney farber. sidney farber was a pathologist. he began in the 1940s. he was so-called doctor of the dead because primarily pathologist in the 1950s would perform autopsies. he was a pathology he specialized in children pathology and typically bodies of children who had died in the hospital would be whittled down into his basement laboratory, which was no bigger than about 12 feet, kind of a frozen cube at the bottom of one of the buildings. so that's where we are in 1848.
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and then, ferber became interested in trying to find a mechanism for an understanding of disease, which was extremely lethal, and that was childhood, acute leukemia and that's her story begins. it is a disease that typically, although not always affects children and usually in the 1950s it was almost uniformly lethal, 100% mortality. often kids to die. they would be diagnosed and die within a span of a week, two weeks, sometimes visit the blogger and die soon after. he became particularly interested in this and one of the reasons is leukemia could be counted. as they talking about and about,, science begins with measurement. whenever you can measure, you can perform scientific tv. this is a time for cat scan to
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memorize, so it is hard to come the inside of a tumor. leukemia could be counted because he could draw a drop of blood or perform bone marrow and you could see the look in exile and thereby say this therapy didn't work. it was an objective mechanism by which one would have a conversation about the increase or decrease of leukemic cells. and he became very interested in this. now, ferber soon figured out one of the things that would be interesting would be to define a chemical that would thereby kill these leukemic cells and launch and therefore launch chemotherapy. it turns out there was an indian chemist, a chemist for india. india had come to harvard to study at the school of tropical house. now he didn't know, there's
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nothing tropical about boston. so yellow was stuck. he writes in winter, stuck in the middle of winter he couldn't find a job and he found a job in fact cleaning urinals. that was the best job he could get. but somehow three series of exchanges coming eventually find a job at the department of chemistry and made several fundamental discoveries. he discovered tdp. he discovered -- some of you may know it's an important molecule. and several other discoveries. but because he was indian, he was denied tenure and was sent off from harvard -- he sent himself off to a pharmaceutical company in new york called butterly, a subbranch of a company and they are he took up a problem, which was of great interest to him. and that is he began to
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sympathize many vitamins, synthetic versions of vitamins. and one vitamin that is used particularly was folic acid. and in the past, an english physician, a young woman had figured out that folic acid was responsible for the group of normal blood cells. so in other words, often in women, particularly pregnant women come if he didn't have enough folic acid, your blood wouldn't grow normally. so farber began to put all of these things together piece by piece. he said a blundering, wait a second, the folic acid is required to make normal blood grow, then could it be if you bought folic acid you could lock the growth of them at that point, which is the canyon appeared in other words, he said to himself, folic acid is a key factor for the growth of normal blood cells, then could one take an anti-folate and thereby block
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the growth of leukemic cells? and so he began to fantasize about an anti-folate and this was the drug that had been discovered during the process of finding the opposite, synthesize and anti-folate. he sent him an anti-folate and he began to inject -- farber began to inject children with anti-folate and demonstrated for one of the first times in history in remission and childhood leukemia and thereby invented chemotherapy. and i was farber's moment in which he comes out of his basement. and in fact, the idea of using anti-metabolite is central to the way we perform today many farms of cancer. but that is the back story. the front story was that that's the case, that's the case there is an interesting story about folate, who was the patient? who was the first person to
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receive folic acid? i wanted to tell this from the eyes of the child, not the eyes of the plaintiffs would ministry because it seemed again it would violate the fundamental principle of the book. but then, this is page 16 of the prince edward to second, have no idea child is. i'm on page 60 and i can't find the first patients -- first series of patients with leukemia. the only thing i knew about this child was he was three or sold and that he had lived in boston and his initials for rs because that was all that was in sidney farber's paper. i was in boston then and began to send out e-mails, which would say, if you happen to know with leukemia in the 1940s, please call me, please write me. months passed by and there was absolutely nothing. no response.
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and i kept saying to myself, i'm on page 60 in this book is never going to get written. and then i got rejected and went on a vacation to my parents house in india and someone said to me, the chemist has only one biographer. and someone said to me the biography is about 85 years old, but he lives three blocks from my parents house in india. some of that going to to yell as biographer. we're having a conversation, talk for an hour but is chemistry and better, et cetera. before you go, i don't know if you're interested, but i was in boston in 1950 visiting sidney farber's clinic in order to comply with this biography and i have all his patients with leukemia. and this was -- was a stunning
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moment for me and out of the fires came a series of patients names and the series of pictures and that's how i found this child -- this missing child. robert sandler, a 3-year-old child and affect the boston sunday herald had printed a picture of him in 1948 when he had just begun to respond to chemotherapy because this was an historic moment for medicine. none of this is searchable. this is not indexed, so i would've never, ever discovered him. so in a sense, this became a metaphor for writing up this book, which is the you might look for something and yet in reality you might find it 6000 miles away. the second metaphor was things always come around. there's a circularity to this process, to history. and so, i came back to boston,
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now armed with the name of this child and then using the medical records and using the boston directory address book, i could find his parents names. and using the record -- the certificates of death, which are publicly accessible, i could find the exact time he died, where he died, we been buried, et cetera. and all of a sudden, the story could have finished came alive for me. and again, that's how this book was written. first passage avt was now going to be what i call -- now they've given you the behind the scenes look at the front of the same foot about what happens once you've done all of this legwork, as it were, and found this child. how then you can construct a story. again, piece by piece, for me it all started coming together.
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here's a section of which i reconstruct the story of the child his house. seven miles south of the longwood hospital in boston, the town of dorchester, which is where robert sander lived as it turned out as the tropical new england suburb between industrial settlement in the atlantic to the east. the late 1940s, waves of jewish and irish immigrants corporately engineers, factory workers settle in dorchester, occupying those of classes that make their way up through the avenue. again, writing this choice, and i could go back in the history of dorchester and read about the history. it turns out the father was a shipbuilder. again, he was now linked into the larger history of the town of dorchester. dorchester reinvented itself as the quintessential suburban family time at parks and playgrounds along the river, the golf course, church and
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synagogue. on sunday afternoon, families converged at franklin park to walk through parkways were too much ostriches, polar basin tigers at the zoo. again, a small note here, which is when i was writing all of this, i kept thinking i went and looked out a book might of been his window. i don't know exactly where he lived in terms of what floor, but looking up, and looks into the park, which at that point of time as part of the zoo. i kept thinking to myself, if i was a 3-year-old child, what would i remember about that new? 83-year-old daughter attend and i kept thinking, what would it be? it would have to be the animals. so it took only a couple of readings to figure out their ostriches to the zoo. what was very nice is if someone came to me. i was doing one of these readings and someone came to me is that how do you know their ostriches in this new? is so nice that the writer,
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filed away in the back of my cabinet was a little article about the fact there've been ostriches that dorchester park zoo, but it was very nice. bob is to give you pleasure as a writer. in the house across from the zoo, child of a ship worker in the boston marriott so mysteriously ill with a low-grade fever that waxed and waned over two weeks without pattern, followed a increasing power. robert sandler was two years old. his twin -- it turns out he is between imperfect house. truth being stranger than fiction, we talk a lot in this book about how genes are debated to cause cancer. if you wanted to find a mechanism to describe this, to describe the role of carcinogens and internal genetic abnormalities and the idea they can sometimes be a family history come you'd probably choose to identical twins and one of them would develop cancer
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and the other would not and that would allow you to begin to enter the biology of what makes one twin had cancer. and yet, i did not do this. and yet of course there was a twin. and therefore sets up the capacity for this discussion to happen down the road about the idea of what is between me and? what does that mean a genetic terms for cancer? now we enter ferber's paper again and goes through the remainder powhatan, how credible medical writing can be. in a very cold paper, there's the story of human beings and whenever doctors exchange faculty, what they are really exchanging again i think her stories in some ways, stories dressed up in technical language, but ultimately when we turn to ferber's paper and then literally restating within that paper. 10 days after, roberts condition worsened significantly. the temperature climbed higher,
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compression turned from her seat to milky way. he was at children's hospital in boston and explains, nor can a source of mixed blood was visibly large tv downlink and overserved that, nor can a source of mixed blood was visibly large tv downlink and overserved that, nor can a source of mixed blood was visibly large tv downlink and overserved that sandler arrived at the children's hospital a few weeks after he had received and overserved that sandler arrived at the children's hospital a few weeks after he had received his first package. on september 6, 1947 can he begin to inject sandler with acid or paa, the first of the entire fully. consent to run the child for drug coming in a toxic drug was not typically required. parents were occasionally informed about a trial, the children were almost never informed. the norberg called for human experimentation required explicit voluntary consent from patients was drafted in 1947 and that's literally one month before the strike, less than a
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month before the trial could it is doubtful they'd even heard of such a required consent code. the truck had little effect. over the next month can return lethargic and developed a limp and result of leukemia on the spinal cord. the leukemia burster one of his bones, causing a fracture and unleashing a blindingly intense indescribable pain. by december, the case seemed hopeless. the tip of standards being merchants and other drop down to his pelvis. he's withdrawn, listless, swollen and pale on the verge of death. at september 28, however, and we know that from sydney's paper is coming her seat and stifle it. this one was called him an actor an actor and comic chemical with a small change from the structure p8. he smashed it up as soon as it arrived and began to inject the boy, hoping for a minor reprieve
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in its cancer, but the responses market. the white socal and which it claimed astronomically, 10,000 september and nearly 70,000 in december suddenly stopped raising and hovered a plateau. the count started to drop the leukemic draft and all but disappearing. a new year's eve with one sixth of its value. they hadn't finished it under the microscope thermonuclear white cells, but temporally abated, frozen into them hematological stalemate. on january 13, 1948, send a return to the clinic walking on his own for the first time in two months. his spleen and liver had shrunk so dramatically that his clothes had become loose around the abdomen. again, little observation in a clinical paper. and he says, the irs clothes had
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become loose. what an amazingly vivid description. i mean, if you want to describe remission of childhood leukemia, but in amazing choices simple words will tell you the child had become so swollen that his mother had to make the close and now this child with the spleen receiving from his clothes became the synopsis remission. you don't require very much to go into a medical paper to reconstruct the story so that it. his bleeding has stopped, his appetite ravenous as if he were trying to catch up on six months of last meals. by february, the child's alertness, and trish and inactivity rate equal to his twins. for a brief month or so, robert sandler and elliott sandler seemed identical again. like all stories, this also has an epilogue and the epilogue is more amazing than the stories of. about 10 days after the book was published, i got a phone call
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from said you need to sit down because this is an important phone call. i was writing a grant on my computer and i sat down and it was elliott sandler on the phone. and he walked into a bookstore, number have been known about this book, remembering the story of his twin who died at three years old and people who have a copy know the book opens to robert sandler in 1948 and to those who became before-and-after had. and he opened the book. he lived in maine. i would've never found them. he lived in maine, opened a book and saw his brother's name through the brother had finished he went back and told me this amazing story, which is his mother, helen whose picture is in the book because i found her picture from the saturday
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morning post. holliman roberts and elliott and the whole family was jewish and this was a time when -- it still remains she was a deep believer. and as many of you might know, opening the body, performing an autopsy after death is considered a violation of think steve n. allen didn't want her child to the autopsy, but ferber was a pathologist then the only way he could learn from his first remission was to perform an autopsy. farber had made helen sandler should let her open roberts body and perform a non-topsy. finally he had really bagged her and said for the sake of medical history, for the sake of medical science, latvia finished idea. she said fine, do it. and she said elliott, she told me this decision had haunted her for decades.
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it was the wrong decision. i think the finest praise who indirectly said to me that the proper story to a close. she said no proper sandler has found a rightful place in medical history. it was left deferred ducted gong member had come to an end. it is in some ways a finer phrase than anything i've personally received and perhaps the most moving thing that happened to me. i think i have time for one more passage that i'm going to need this from the end of the book in which takes is a very different kind of challenge. the first kind of challenge i describe to you is the challenge of story making, which is how to populate a boat. it is the challenge that appears in the content. a book like this faces a different kind of challenge that
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is the challenge of summary making commotion at the end of the book on how to summarize for a thousand years of history? how does one prepare to give -- how does one tie up all of this? the quick answer is there is no simple solution and that is something you learn in the book. one of the challenges of this book is there is no answer. i once heard about the says this is how you cure cancer. eat broccoli. nonsense like that. and so here i take up that challenge by actually performing an experiment. and i recount the story -- earlier in the book i recount the story of a persian queen who is described in no less than about four lines and becomes one of the earliest descriptions of what might have been breast cancer. again, we don't have a word for cancer and this time.
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it of course is a description of the early history of the west, focusing on greece, since a little bit of a message. he describes the idea that the queen of persia developed swelling in her, and mass in her as some people translated. and her response was she was so ashamed that she had herself in her shame. river 1950 calling at "the new york times." she had herself and her shame it would let anyone examine her to the greek slave intervenes and promises to cure her penny does cure her high-performing one of the first ever mastic demands or
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lumpectomy is. as a return favor she tells him she would persuade her husband, a the king of persia was debating the eastern border of persia she will persuade him to invade the western border of persia in taurus greece so they can turn back to native greece. in doing so, this launches the persian war. so here's this woman -- and i'm quoting. and literally cried and from history. this is the moment in history when the face of persia at the returns from its easter feast of the western faith because of this illness. the urologist dedicates four or five lines and of course this launches the early history of the west, the turning of the face of persia away from its eastern border towards its western border, launching the very famous west and persian
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wars, so we now, 500 pages later returned back, recall the persian queen who likely had breast cancer in 500 b.c., imagined her traveling through time and one after the enough. as she moves through the history, the tumor remains the same. they recapitulate pass defenses and considers future. how is the treatment shifted in the last 4000 years and what happens later in the new millennium? 's first in 2500 b.c. the name for the elements, provides a diagnosis that there is no treatment he says, closing case. 500 b.c., the most primitive form of the site to me was performed by her greek slaves.
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200 years later by precinct and raise the tumor as aquino's nose, giving her elements and name. as atlantis is the derivation of cancer because it imagines cancer is a crab great under the skin of the blood vessels spreadout think the legs of the crab under the sand away from this moment of inception it is metaphorically for me this illness. it does in/five the black crowes purse from her body in the tumor keeps growing, relapsing, in dating and metastasizing. they understand little commode away cancer with niacin scalpels. some are for real historical text. from flood from the holy water,
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chemicals as treatments. 1778, her cancer is the same the stage, localized breast cancer for the farmer or a localized cancer from hunter recommends a local operation and for the latter he recommends remote sympathy. when he reemerges the 19th century, it's a new world of surgery and in 1890, breast cancer with the boldest and most definitive therapy thus far brought up on the stuff with removal of the deep chest muscles and lymph nodes and collarbone. nearly 20 centuries, by the way, that treatment i go through the story of that in the book turns out to be essentially a failure. it takes 90 years before patients and that tourists can again to convince themselves to really put the idea of surgery to test. when it's put to test and years after the convention, 500,000 women treated later turns out to
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be no different from non-radical surgery. oncologist rich buttery using local x-rays. the 1950s another generation assertions are and to combine the two strategies by moderation protruded locally with olympic me followed by radiation. the 1970s, and that their appendix emerge the chemotherapy will diminish the relapse and tumors test positive for recapitulate things in the book. the turmeric test positive for the receptor and democracy is also added to prevent relapse. in 19 essays, tumors for their discovery to be too amplified into surgery, radiation, tamoxifen is used for set in. it's impossible to enumerate the precise impact of interventions of survival with direct comparison between 500 b.c. and their fate in 1989, the surgery,
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chemotherapy, hormone therapy have likely added anywhere between 17 and 30 years to survival. diagnosed at 40, can reasonably expect it to celebrate 60th birthday. in the mid-1990s the management takes another concern. diagnosis at an early age and ancestry raises the question whether she transmutation the terms i've introduced in the book. the genome sequences at a genome content screening program to detect the parents in the unaffected by a spirit who choked on her circuit testing. they offered either intensive screening, prophylactic bilateral mastectomies or tamoxifen to prevent breast cancer. for the daughters, the impacts of screening prophylaxis may be
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dramatic. an mri might identify a small lump of one daughter and may be found to be breast cancer surgically removed. the other daughter might choose to undergo bilateral mastectomy have been excised she met without her life for breast cancer. in each one of the sentences corresponds to the seminal clinical trial. it basically as an oncologist of note each one refers back to a very major single trial that proves or disproves a particular way of management of one positive for two positive negative breast cancer. but does so i hope in a way that's understandable and somewhat humanized. moving into the future now, in 2050, she arrives with a flash drive containing the entire glance at the genome, identifying every mutation communications might be organizing to raise.
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not for them identify the parts first right of the camp or spirit therapies against the sponsoring to relapse of the tumor after surgery. she may begin with one combination of targeted drugs, except disastrous second half to answer together the cancer mutates again. she will likely take some form of medicine whether to prevent, cure or tallied her illness for the rest of her life. this indubitably is progress. before we become too dazzled, it's worthwhile putting it into this. the prognosis unlikely to have changed by more than a few months and 2500 years. it develops gallbladder cancel. her survival changes marginally over centuries. even breast cancer shows an outcome. if the tumor had metastasized,
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unresponsive keynote or p. and her chances of survival has barely changed since the clinic. the chronological leukemia or hodgkin's disease in contrast and are less of increased 30 or 40 years. part of the unpredictability is that we do not know the biological basis. we cannot yet fathom, for instance, what makes pancreatic cancer are gallbladder cancer so different. what is certain however is that even the knowledge of cancers biology is unlikely to eradicate fully for my lives. we might as well focus on prolonging life rather than a lemonade dust. the war on cancer with sp1 by redefining victory. so that is the second passage. how are we doing for time? is there time for one last passage you should be back up? am going to read the very last passage is the final summary of the book.
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this passage was actually probably the hardest for me to write and goes back to the question that john todd about why i had written this book is an answer to a question that a woman had raised them so we return to the story of this woman to the incredible women who i treated while a fellow in boston, she had had an abdominal sarcoma and had relapsed and had an interview that mission, incredible remissions, by the way, caused by a new drug called an accident or reback, striking remissions. and she had an unbelievable character, a psychologist who
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had essentially followed the trail of the strips are at the country, moving from one of clinic to the next, enrolling herself in getting information on the web, creating her room community every time around herself and she would engage and ask questions and pulled herself for trials. at one point of time she was receiving chemotherapy, using one of these drugs to mobile living in a trailer home. she found herself in homesite is move onto the next one, almost like reading her a little trail around the country, an unbelievable person. and finally, she had her last response and then her tumor became completely resistant to did not respond to even the newest forms of therapy. so this is mine -- this is the last time i see her. so i'll pick up the story. the new drug from the last time she had to drive through
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september response to did not work for long. by 2005, the cancer had spread out of control, currents of thought she could record its weight in pounds as she stood on the skills of the week. even her pain -- eventually her pain it is impossible to walk from her bed to the door she had to be hospitalized. a meeting that evening was not to discuss drugs from the trade should make an honest reconciliation between her and her medical condition. as usual, she beat me to it. when i entered her room to talk about the next steps, she cut me off. she told me no more trials, no more drugs. six years of survival peeked out between 1999 and 2005 had not been frozen. they clarified and cleansed her. she severed her relationship with her has been an intensified bond with her brother and oncologist. her doctor, teenager in 1999 and now a mature software had grown into her closest friend.
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cancer break some families and makes them. in my case it did both. she wanted to go back to alabama to her own home to die the death she'd expect it in 1999. when i ricard's final conversation, and conversation, embarrassingly enough the objects in the stand are physically than the words. a hospital room with a sharp smell of disinfectant and hand soap, the unflattering overhead light with bills, books, nail polish, true reimpose currents. the standard issue with a bunch of sunflowers perched on the table by her side. jermaine was sitting by the bed, one might thing going pashley town, wearing her eccentric combination of clothes and some unusual pieces of jewelry.
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her hair was carefully arranged. she looked formal, frozen, like a photograph waiting to die. she seemed content. she laughed and joked. she made wearing a cube seems somehow undignified. years later in writing this book i finally put into words what the meeting left me feeling so uneasy. by the objects seemed like symbols in march or made seemed like an actor playing a part. but then i realized was incidental. the characteristic that once seemed spontaneous and impulsive were in fact almost responsive responses, reflect it to her illness. a closer listen that it gives
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the growing of tumor. her necklace was distractedly large so as to the full attention away from her cancer. her most topsy-turvy with bubbles and pictures. the hospital room with flowers and cards stacked to the walls because without them it would devolve into the anonymity of any other room in any other hospital. she didn't utterly get the precise angle because the tumor had invaded her sign and began to care less whether they, making it impossible to sit in the way. her casualness of study, her jokes rehearse. her illness tried to humiliate her and made her anonymous. she had responded with a vengeance, moving always one step ahead, trying to with it. it was like watching someone in the game. every time trimmings deceivers, imposing terrifying constraint on her, she made an equally assertive move in return. the illness acted and she
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reacted. it was a morbid don again that he taken over her life. she dodged one blow only to be cut by another. she too was like carol spread queen thomas subtitling furiously to keep still in one place. jermaine seemed the evening captures something essential that the struggle to keep pace you need to keep inventing and reinventing, learning and am learning strategies. jermaine five cancer desperately, fiercely, madly about the energy of generations of men and women who fight in the future. the quest had taken on the limitless journey through internet blogs and teaching hospitals and clinical trials halfway across the country which will landscape the more desolate, desperate she deployed every last morsel of her energy, mobilizing her kerch, summoning
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her will and wit and imagination until the final evening as she stared into the folds and found it empty. in the hunt of last night, hanging onto her life by no more than a tenuous thread, all her strength and dignity was associate encapsulated the essence of the 4000 year-old work. june 2010. thank you. [applause] >> hi, dr. marcucci is going to take questions now. i'm going to bring around a microphone, so please don't search her question to you at the microphone. also because this is being filmed for tv, for privacy reasons, please don't ask any personal questions. thanks. >> he made personal medical questions. you can ask questions about me. actually, i'd started by name by asking john a question and that is, tell us a little bit about
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what's happening at the national cancer studio. you come here from washington. tell us about what's happening in terms of this new administration in the sputnik comment in which you imagine would be happening in this administration with respect to cancer. >> thank you. i first wanted to comment. i was most impressed her eloquence and ability to communicate. i think i've been able to educate america and the world about cancer, it is really my hope that someone in a field other than medicine will probably be the one to find the answer to cancer, just like the church and was found on the battlefield. one lesson i learned, very often it's the medical students, the youngest trainees who asked the most provocative questions and to move the field of medicine
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forward. i wanted to congratulate you. i was most impressed during your discussion of serendipity and i really hope there may be the opportunity for someone here tonight to think of new answers, just like the apple slogan think differently. there's a lot of excitement in washington d.c. right now. there is a pitched battle to either change or repeal the affordable care act, but one area that continues to move forward is the amazing amount of work, clinical trials and studies being undertaken at the national institute of health. i hope that the budget will be able to be approved and funding will be preserved to continue all the incredible work that is being performed at the national cancer institute. the institute offers tremendous hope for patients from the entire world. and it appears that the commitment of the obama administration to discovery, to innovation will continue.
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so i think for cancer patients all around the country in the world, that there are many great things yet to come from the institution. >> what are the battles? who is fighting what? >> the battles are political. they are about how we are going to change or repeal the affordable care act. and one of -- there are many strategies. i would turn your attention to an article from "the wall street journal" last year about the strategies to either defined, disallow, repeal or to change the legislation that was passed last year. it is really my hope that we can deconstruct his and to move about the acronym for debate and identify those portions of the law which are working well and identify once they need to be improved and to keep this process of health reform moving
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forward. >> that's absolutely vital. yes, questions. >> hi, i'm dr. jordan welfare, and old-time pediatric oncologists. i want to make a comment. this is a fantastic book. you have been right on. >> thanks so much. you know, one of the things again because of the constraints of time, to draw a character in a book like this, one of the ways you really rely on lots of primary interviews, aside from the archival research, a lot of primary research and i think they're about four or 500 interviews went into the book
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carried on over time. even for instance, painting a picture of sidney farber was to do that, too, and from different angles. and you know, what is important is human beings are complex. even a character like farber, a lot of people didn't like him. he was an unpleasant character, it's important to convey is otherwise you end to read a history that's not real. >> have you ever been a factor in the war? >> at the good question. not in the sense that you might understand war. i have never been a doctor in the military forefront. one might say that this is also
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a war in the sense that when we sometimes fight wars between people and human beings fight each other, but sometimes we fight even more important moors against things we can't see. and i might add that cancer is one such entity. i don't like using the term war sometimes because it feels as if patients become soldiers. and if you don't survive coming you become a loser in such a war. so i don't like using the metaphor. but for some people it works. for some people mentioning us in a battle against cancer is important. the usual approach is that that is a metaphor that works for you, you said. you know, who am i to tell you what metaphor to use. so yes, the quick answer is i have never been, but in a more abstract were. and there are other wars also
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being fought now against more abstract entities, political wars. a part of that is also part of this book. how does one fight a political war? how does one create strategy, which is not only scientific strategy because one thing we know is that if we are to engage cancer, whether it be war or not, we've got to engage cancer, the solution can't just be a scientific solution. they would have to be a political solution come a cultural solution at all of this eradicating tobacco. one requires a cultural and political solution. you know, solving the genome of pancreatic cancer is completely different but requires another strategic element. so every piece of us, every piece of us as human beings is engaged in this and everyone can contribute it in.
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>> you seem to be speaking primarily of tears of cancer. there's is an increasing amount. did anyone of you comment on your outlook towards the efforts being made in any optimism? >> i have several comments about that. there's a large selection that tilts and prevention. let there be no mistake that one of the most historically -- in fact, one of the most seminal moments in the war on cancer is when this idea of fighting a war begin to fade away that continues today. my thoughts about prevention are many. i'm not going to talk about them at great length.
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i'm going to make two comments. one comment that remains shocking that the most preventable carcinogen is still at large. here we are fighting this complicated donald on the hill about how to do this, that or the other about health care costs. meanwhile, the largest known carcinogen -- there's a great irony in all of this. people talk about radon were some known carcinogens. fully acknowledge carcinogens. it's a little bit like we're not talking about the huge elephant in the room, which is tobacco. so my quick answer is some of the battle against prevention is going to be political in a cultural battle. but the second point i went to race, which is to be interesting
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as it seems that the silos of prevention and treatment in biology are collapsing in many different ways and that's very encouraging. in other words, we used to think cancer prevention used to live in one compartment in cancer treatment people used to live in one compartment and others used to live in a separate compartment, but that's not the case. i give you one example. tamoxifen is a good example of that. here's a drug created originally to treat advanced positive breast cancer, but it turns out to have a role in prevention used tamoxifen as a preventive agent appropriately identified and focused. tools such as, which was originally invented as diagnostic tools to diagnose breast cancer can be used in the preventative sending. in fact, even the cancer
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genomics, understanding as an important prevention, particularly in breast cancer. so there is a way in which the new biology of cancer is forcing us to rethink the silos. it's very good because it will allow us to rethink prevention away that just doesn't relegate prevention to one end and this fusion of the two disciplines have been happening for a while is very encouraging to me. any comments? >> ima surgeon. we've burned them, froze them come used ultrasound, cut them apart and made vaccines. if we can catch them early enough, we can cure them. jimmy the question is about the prevention of recurrence. and what we haven't solved. you can have a tiny tumor and
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you can remove it in its entirety, but months or years later, you'll discover it read out throughout the body. conversely a single largest tumors and they never recur. so the fundamental next up from the surgical give is the prevention of metastasis recurrence. >> viruses and bacteria evolve and so therefore the war against them is never over. it's always the temporary victories for decades. the cancers evolve with their 5000 yearbook. cancers -- in other words, cancers are involving inside, so
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in other words, within every tumor, there's kind of a darwinian battle going o, withiy tumor, there's kind of a darwinian battle going on comic even without treatment. within every tumor there are clothes going out which are resistant to escape your immune system. within every tumor and derek lowe and double move to other parts of your body. when you take chemotherapy, you will kill that she might kill many of the cells, but they're a bad be found in escape and therefore will evolve out of that. so cancer -- we talk about the fundamental terrine miss them and that is part of the secret of how unbelievably successful cancer cells are innovating because every time, like we come back and every time you do something, the cancer cells are
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sort of pushing back, but cancer cells are evolving. and it is much like treating a disease -- it's much like treating a bacterial illness are much like treating a disease that viruses as constant vacation in evolution happening. it's like galapagos trapped inside the body. >> my question is regarding the role of the patient during therapy. when i was diagnosed, my center made it very clear with patient oriented and that i would have deciding what direction i was going to take, but the reality of it is that the time when it happens that everything moves so fast, that you really feel like you don't have a whole lot to say because you don't know very
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much. do you have any comments on not? >> well, my comments in general -- that's an unfortunate situation. that's a situation i hope we don't find ourselves increasing over time. i hope that we have given the pressures of time and money that are occurring in health care. i hope we have time to listen to stories and figure out how to best treat a statistical entity, but a human being. i have to say it's very tough. sometimes it requires the kind of listening skill, which i think we as doctors have forgotten. some people might not want a certain kind of treatment. and it's very hard for physicians to listen to that. we've honestly forgotten that listening skill. i hope that we have a way to
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keep that in medicine. did you have any idea? >> well, my thought was i didn't feel like my doctor wasn't listening to me. i thought like, i am not someone to study cancer my entire life. i know people who had it, but i know very little about it. i get to a level where i can ask a question and make some definitive decisions. i would've had to move so fast i would've had to be reading up on everything. so when it gets right down to it, i have to trust the doctors, which of course i do and i chose doctors that i trust, but i think as a patient -- a patient ..
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>> they don't have to be the person who is the expert all the time. no one is the expert. i am not the expert. that is my strategy. >> we have learned that web research is the kiss of death. [laughter] >> it is. >> do you think the vast quantity of chemicals used in the various processes are contributing to win increase in the incidence of cancer? >> that is a tough question. some chemicals may be
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contributing but i think that on the other hand,, one has to be careful of the idea of high per carcinogenic environment. it creates a panic about the environment that i do not agree with. my general thoughts is every chemical, particularly those that reach a certain concentration in our environment need to me quite rigorously tested and are testing mechanisms are improving. we used to have a primitive way to test, a very, very primitive and relying on the fact that they cause mutations. not all decisions do these personages to. it is very, very important but primitive developed at berkeley. but we have much better test for that. but with that said i disagree that every chemical
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needs to be tested and is exactly the right thing to say. but i disagree with the idea that we have paid generally more carcinogenic environment because we need to find what those are. it is like saying it is a little bit carcinogenic. but i have to drink the water. we have to breathe the air and tell me in a quantitative way and so let's be specific. what is the chemical? how can we remove it? and then remove them from? i have a question similar to that. was i supposed to start?
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i have a little bit of education that makes the somebody dangerous interesting been avoiding the paranoia the press encourages, or the percentages of cancer that basically just natural mutations, things that just running around living in a clean room all your life lowered to keira and i am sure these are different for every type of cancer. we do know the answer with smoking but excluding long cancer is there a sense of the percentage that is a just natural percentage that come with age and which ones might be industrial carcinogen oriented? >> that question as you can
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imagine is an extremely difficult question to answer. it is extremely rare for cancer. there is an old ad agency bd realogy that larger rare risks are much easier to assess the and common risks. in other words, if there is a sudden epidemic of liver cancer which is associated with a particular toxin mozer easy to zero determine but when you have a small increase risk of a common form of cancer like breast cancer, to detect a huge study from the very substantial, but nonetheless relatively small relative risk of increase of breast cancer with home-- for replacement therapy. this is large enough to
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register on the epidemiology's scale but it takes a sophisticated study to figure out. i am not sure we aren't there yet in terms of technology to figure out the small, then risks are in the end can one really determined whether this was a small risk created by a carcinogen or a natural mutation? for some cancers it will be very, very difficult. >> thank you for that fascinating talk and fascinating meeting. you talk about how radical mastectomy was institutionalized as a treatment for breast cancer. and it took 90 years to understand that it was unnecessary and effective. maybe you can talk of other examples that you have come
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across and in particular, are there treatments that are part of standard therapy now that 10 over 20 years from now we will think of as any factual core unnecessary? >> i certainly hope so. [laughter] i did not want to write to the way history progress leading to more progress and the low ones that been made very funny plays. many stories in the book have to do with medicine is a self-fulfilling prophecy or learns to believe in itself. mastectomy is one of them back to breast cancer in the 1980's, there was a strong sentiment that many
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researchers believe giving radical chemotherapy would cure breast cancer but so radical replace -- wipe out your own bone marrow to replace it with your own and had it up another decade to disprove that and part of the reason was that patients did not want to enroll themselves in the trials. they were so convinced by their doctors that this was the right thing to do that nobody wants to be randomize with the placebo. the doctor said we believe this works. you believe this work so why go through the minimization? massachusetts there was a law that was past that pervade and insurance company for not allowing
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them in other words, that the insurance companies would skimp, which they were doing on breast cancer therapy but it was breast cancer therapy mandated by law. they have example after example and i think this would engage itself on many forms of therapy from today. >> i will repeat the question. are you asking what causes prostate cancer or why does it come in so many varieties? which of those? [laughter] >> [inaudible]
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>> i think when we don't know the full answer to that question but the prostate is one organ where malignancy develops and then had a remarkably high rate. what is very tricky is prostate cancer comes in very different forms. there is one form bad as nine -- does not metastasized and there is another form that metastasizes and will kill you. we have not yet begun to figure how to discriminate. it is a huge problem that is again and off the magnitude that it would make a difference and with the national health care budget because for every 10,000 those you should not be treating you are piling up cost the but of
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course, there is a cultural parts of the answer that in the absence of the knowledge, how to read the cave as individuals or how does one tell a man, 80% more likely your prostate cancer will be the ones who watch and wait? in a culture where we do not understand enough and cancer has taken on the current metaphor how does one communicate the complexity of the idea of who is comfortable and who is not? if you go on the web, you will find 10,000 opinions of testing with the psa. this is of the enough importance and so common that will make a difference to the budget because the numbers pile up.
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the usual answer is technology and a deeper understanding and while be are here trying to figure this out, the good kind a and bad kind of prostate cancer and then the problems you're having so encourage science is the best thing that we can do. >> have we looked talk about the food additives i spend its time in a book about
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esther's said -- estrogen and pesticides but it is an issue there is a deep interest in looking at it in particular in such as hormones. and those at not just the old but a combination of molecular biology and in general, with a exogenous estrogens there is a smoking gun whether people agree or disagree with that. >> can you comment on the abolition as a writer?
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>> in the sense of? >> was this your first book? it is extraordinary. >> my general approach to retain this book or any riding that i do happens to be through my scientific work i like to write books and answer questions. if i have a question i will write a book and i had a very urgent question. in terms of writing this particular book, and if you are a reader of the book and my sense that as the book progresses from the 200 page to the 400 page, and again again, it seems to be it is obvious i am learning to write to buy the 400 pager i am a different writer from the first page. i work backwards and i tried
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to clean up what i had done before but again that mark remains and i do realize the writing is self in false. in terms of process, i have spoken to others already and it has been written about, i made deeply discipline director in the sense i write small snatches here and there and i write exclusively in my bed. [laughter] i propped myself up with pillows and when i was retain all of this, often i would have early early mornings and right. the most important thing in terms of the writing of this
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book and if you are a writer, it is clear to you that the content was relatively easy for me to write. it it was the content how does one go from 1994 back from 2000 and then move forward 580? how does this fit together? sometimes the stitching is very tenuous and in fact, said discipline of this particular book was that stitching and how does one manage? the answer is i tried to imagine and the kind of person who will go through the book is someone i trust to move through those scenes
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and they will rise to read it and it gets a this finance gets pretty dense. i did not spare the most contemporary details. we talk about cancer genomics from 2008. it gets really complicated but the book lives. those for the features that allowed me to write. one last comment that lots of people have asked me, i have best days ask, i learned to write from those who have written about medicis -- medicis in before me. there was a learning process that raises the question it
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was a very interesting question to me personally that was there something about the indian about this particular book? and i spent a lot of time thinking about to and my answer is the most important saying of being in the and in writing the book is the fact that india it gave me the freedom -- freedom for and allowed me to write about something that was entirely universal, had nothing to do but it was almost as if i inherited a kind of rate teeing tradition that allowed me too not have to write about the politics and that freedom is important to me
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and i am not sure i can convey how deeply that is that i did feel constrained but i can write about something relatives a universal and i think for being in america for that and the political freedoms of my country, countries. >> last question? >> in recent years a lot research and has been linked to demoralization of cancer and the day saint it will come out of this war? >> what is not included? in general i included things scientific things that have led to human their priests. i tried to avoid, if you
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really trace back everything that is in the book, would ever goes into the book ends up with a human being, at a certain genetic understanding of cancer and it becomes a drug as a preventive medication -- of the things the an understanding like metastasize, the immune system, we're very important and fundamental biology of cancer but it did not meet this new test to be transformed into something that would impact the way we either treat lowered deal with preventive mechanisms of cancer. i will be forced to write the addendum to this book. last question. >> when my uncle had leukemia, they told him at johns hopkins that they had done everything they could
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and beyond this it was something greater. how much do you think that either a positive attitude or a belief in a spiritual thing plays a role to cure cancer? what is your experience? >> it is good will and without question because i would give their relatively provocative answer. i try not to believe this psyche has a role to cause cancer for the following reason. because i think it victimizes the cancer patience. when people say there is a link between the psyche and cancer, i think that is the things that hands to a cancer patient whose plate is already full, twice the burden of the disease. i tried to shy away from that kind of thinking because it does feel negative.
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plenty of people who have had intensely positive attitudes about life with incurable cancer and others who are unbelievably depressed, or all sorts of mental illness who have lived perfectly healthy cancer free lives. the ada that the psyche because it is cancer i have an allergy. that is said to my belief the psyche modifies one's ability to heal? yes. the there is no archetypal psyche. someone might use grief to heal. somebody may use depression. for someone dealing with their illness, it might involve entering as space full of grief for depression and that maybe there mechanism. and to force my understanding of whatever spirituality is, of a positive attitude, again ends up with victimizing a patient.
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who will my to say what is your positive attitude? you may decide you have the intense feelings of grief around url must. i can try to help people when the grief, what i call pathological form, but even then i tried to step back and particularly am allergic to the idea the reason you're not getting better is because you're not thinking positively enough. that is part of the reason i wrote the book. there are so many self-help books about cancer that say that you're not getting better enough and i am very allergic to that and i start off by saying i will not go there. i respect your decision but for me to say that as a doctor creates a cycle of
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claim that i really want to avoid. thank you. [applause]
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>> in this is a book not just about washington law firm but they culmination of everything i have learned about riding about lawyers and law firms back in the
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day when you are a newspaper reporter you learn early on underneath every decision and behind every election and every political thing that happens from the smallest town to the biggest city nobody does anything without consulting a lawyer. i started my journalistic career in greenville mississippi and from there by went on to the camp the tribune and after living in florida for five years i decided that the only place like a possibly live to be better than florida was california and i ended up getting at a job at "the los angeles daily journal" that was i am not even sure if i remember at the time that it was strictly a legal paper. it looks like the "wall street journal" and owned by turney longer, the same as
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that is the associate of warren buffett. i have loved covering sports when i was a kid i'm sure it was not intentional he kept giving me books about lawyers to breed. [laughter] i read all of the books and i remember one of the books that i love the most was my life and gore and i got to interview him when i was a reporter in california which was a thrill of my life. and then after writing a couple of stories about internal law, i ended up getting a job at american lawyer magazine that ultimately led to my riding
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covering the demise uncovering my first polk shark tank. while i was there i had an idea for writing a story of one of the lawyers at williams and connolly to have the greatest dream job of running a baseball team. that was larry i went to his office he was the president of the baltimore orioles. and i got almost all through the whole story to the end and then seven negative was interviewing said i guess you know, about his illness? i said yes. of course. terrible. anyway i began to piece together how the age of 39 years old he was stricken with nine hodgkin's lymphoma
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and was a 36 person the history of medicis and to have a bone transplant. while he was in recovery from this illness, he went to the institute in boston a pipe din the boston red sox and when he got out of isolation they said what is the one thing you most want to do not a you get out of the hospital? he said i want to walk around fenway park greco here it is by the way. [laughter] but i have always thought his story was one of the most dramatic and wonderful stories because 13 or 23 years later he not only survived against all odds but an even greater that
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nobody thought was possible. shortly after meeting larry that i signed nine to cover the iran can track -- country at hearings and in the pressroom while he was represent saying how oliver north and whinney he came to represent you the room would crackle and it still does walking into the ted stevens trial, there is an infectious the in the room that you are present with some of the great lawyers. as a lawyer i am pretty lucky to be in trials with people like that.
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also jim coleman is now at duke when he represented ted bundy with the death penalty appeals. when you're in the presence of these great lawyers, is a spectacular feeling. some of you may have heard if you're watching boardwalk empire did you seal last episode? arnold rothstein is preparing his legal defense one of the characters said you should be a lawyer. he replies without missing a beat the that rather continue to make my living on this day. there is a lot of players in this country that don't
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necessarily all showered praise on the legal profession but fortunately i have been able to me around some of the best denigrate is when i do my 50 best lawyer stories for the washingtonian every year normally i would limit it to three and david kendall would be on their and sometimes i went rotate the third spot and richard cooper was there and bob barnett. i was thinking williams and connally has at least 10 and branded would probably say all 50. [laughter] but i always thought-- thought it would make a great book and a few years ago i did a piece called the firm that runs the world where i talk about
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the concentric circles that enveloped the legendary firm, they represented the tobacco industry in the supreme court cases involving whether or not it should be treated as said drug by the fda but also represent the cancer institute. one of my favorite ones and called bob barnett. this week with david brinkley used to be on every morning and it struck me they represented the network that broadcasts the show, abc, they represented all the talent that was on the show, a george, of brinkley come up roberts, a donaldson income of most of the time they would also represent the talent that was on the show james carville and mary matalin and to cap it off, also the
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attorneys for archer daniels midland which for many years, the part of which is retold in the movie the informant with matt damon. as i look at brendan sullivan's career, i always used to say in my articles about him, brendan sullivan is gone 35 years and never had one client serve any time in jail which is pretty remarkable because by the time people came to him they were four up the creek. it was not like he was defending roman catholic nuns or that type of thing. after a while i began to wonder is that true? did i just repeat the story so many times i believe it?
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i tried to go back and talk about why brendan sullivan has a fashion that he has and the pattern from when he came to williams and connally after defending prisoners' in the stockade the san francisco and the first case when prosecutors routinely sought they did not be given the correct manner possible and i sort of came to realize and i think i explained in the book why he is the widely -- the way he is in his case is turnout the way that they do and the best example is a tax fraud case he had handled where he was going through the documents the government had
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given him in a high-profile case and one did not look great. the ithers were yellow and this looks okay. he held the paper up to the light and had his investigators check out the water marks. they could prove the paper was not manufactured until after the document had been typed and the prosecutor could not find the original document so just had day retype to. that was a classic brendan sullivan which we saw a lot of in the ted stevens case when he was able to prove once again prosecutors had failed to provide the scope of tory evidence that is usually required to do. and the broadcom case that just concluded with the same results. i do find it kind of interesting to me that a lot
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of conservative politicians the railing against the awesome power of the federal government the last couple of months brandon has been a foot soldier 35, 40 years and 77 more perfectly willing to create new-line this of what they can and give more power to the prosecutors. and not see any inconsistency in their positions. it just seems a little inconsistent. i took these and i was able to convince a martin's press and looking at it through the lens of volumes and connolly which is what i tried to do have a basic
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threat is to take the five main characters david, , and larry and those that have left the law firm also what jeff did the ceo of pfizer were from the sony corporation. or marriott and how sayings and actions but in terms of american business and law and made this a tremendously unique firm and in a lot of other ways that i point* out that they don't take lateral partners were a gauge in
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self-promotion. so that is what the book is about and that is the comment that you may get from empire boardwalk i think my characters are all the exemplified the best that is difficult to say because when you write for a trade publication and all the american lawyer was the anti-trade publication writing for a general interest magazine paris a great people in the profession they give for coming as well.
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>> [inaudible] >> robert barnett has built a an incredible practice one of the things that calls the world's most powerful firm that baht's the practice represents three presidents come the vice president's comeback cabinet secretaries and major media figures coming acres on both networks, please saying all the powerful people in washington like pieces on a chessboard.
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and it started with geraldine ferraro. when i called her to talk to her about her relationship with barnett's and how that led to this incredible and remarkable practice that he had come and just about the time sarah palin had been named to be the vice presidential nominee by john mccain who was not williams & connolly client by the way. [laughter] and at the end of my questioning i said say you share the distinction of being the only two women in american history to be nominated for vice president. ojai she called to ask what it is like? she said no. actually senator mccain had called me and i call him
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back and he had called to tell me what he had done. and i said wished her luck and he said she is right here. i will put her on the phone. he put sarah palin online and basically had no clue who geraldine ferraro was. the conversation was very short. when sarah palin book going rogue came out there was a whole page about how sarah palin was going around talking about how great geraldine ferraro was and she called her to thank her for all of them shouts on the campaign trail. i call geraldine ferraro back and said her account is all little different and she repeated the story as it was the first time. i was satisfied to put it in
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the book. but sarah palin a very attractive person, a lot of energy, i watched her show the other night and i saw her stand up to the grizzly bear. but she can tell some whoppers. she does know some walkers. anybody have any other questions? i hope you enjoy the evening i will go over there and sign some books. [applause]
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>> president obama it issued a proclamation this is all across america of. [applause] okay. president obama. we are grateful that he did that and please welcome our special readers. let's hear it.
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[inaudible] we are also excited about reading. and we read all the time. he reads so much he knows about everything. you have to read. we will start off by reading something fun. secretary dunkin and i were big dr. seuss fans. do want to talk about your reading? [laughter] >> we both have two children at home a little bit older than most of view but if we had a net goal for every dr. seuss book that we have read. they are great books and the more that your read at home for fun and leave the video games a lantern of the tv
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tv, if you become lifelong readers you can do anything you want to do. one quick story. my parents were crazy. guess 70 tv's we had in my house? eight? o. i had to sneak over to my friend's house to watch tv instead my parents read to us every night. we did not understand that but it installed stations still the love of reading, whenever it might be, stories, mysteries, comic books, non-fiction, just read for fun if you do that you will do very, very well the rest of your lives. are you ready to hear a story? greenish eggs and ham. have you heard that before? i am samberg out i am sam. sam i am.
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that sam i am i do not like that sam i am. deal like green aches and ham? >> i do not like them and sam i am. >> would you like them here or there? >> i would not like them anywhere. i do not like the green asean ham i do not like them a sam i am. >> do like them in a house would you like them with a mouse? >> i do not like them in the house. i do not like them with the mouse. i do not like this here or there i do not like them anywhere. i do not like green eggs and ham. i do not like them sam i am. >> would you keep them in a box with a fox? >> not in a box not with the fox not in-house not with a mouse. i would not eat them here or there. i would not eat them anywhere.
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firewood not eat green asean am i do not like them at sam i am. >> would you could you in a car? e to them. here they are. >> i would not could not in a car. >> you may like then you may see you may like them and 83. >> i could not its three not it a car you i do not like them in the box with the fox and a house or with a mouse. i do not like this here or there i do not like than anywhere. i do not like three asean him. i do not like them sam i am. >> of train. a train. could you would you on that train? >> not a train or a tree or in a car. let me be. not with the fox were in a box i will not eat them with the mouse or and a house. i will not eat them here or
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there. i will not eat them anywhere. lead too not like green eggs and ham i do not like them at sam i am. >> in the dark? would you could do in the dark? >> not in the dark. >> in the rainn? >> would not could not in the rain in the dark or the brain or train or tree. not a house or a box or a fox or a mouse i do not like them anywhere. >> you do not like three asean ham? >> i do not like them sam i am. >> could you with eight . [laughter] >> i could not with they go to. >> would you could you on a boat? >> i could not would not on the boat and i will not with
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of go out. not in the rain or a train or in the dark or in a tree or in a car. let me be. i do not like them in a box or with the fox or in a house or with the mouse or i do not like them here or there i do not like them anywhere. i do not like green eggs and ham. [laughter] i do not like them sam i am. [laughter] >> you do not like them so you say? try them. [laughter] try them and you may. tried them and you may i say >> sam, if you will let me become i will try them and you will see. >> are you trying them?
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i like green eggs and ham. i do. i like them sam i am i would eat them in about and i would eat them with they don't. i will eat them in their rain and in the dark and on a train. and a car and in a tree, they are so good. i will eat them in a box and i will eat them with the fox. i will eat them in a house and i will eat them with the mouse. i will eat them here and there i will eat them anywhere. i will. i do like green aid and ham. thank you sam i am. [applause] >> i love the green eggs and ham.
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would you think that is? mr. obama is not here. somebody even better and taller. the cat in that. could he be here? where is he? where? tell him to come out. , outcast and a half. katz in the hat to. >> who else? look at that tail. now cat in the hat thing one and thing to all of us
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together and we want to do a reader's pledge with you. are you ready? raise your right hand. the other right hand. when you hear me say something repeat after me. are you ready? i promise to read it. >> i promise to read. >> each day and each night. each day and each night. >> i know it is the key. >> i know it is the key. >> to growing a brain brain -- upright. >> i will read to myself. >> i will read to a crowd it makes no difference. >> it makes no difference. >> silent or loud at. >> i will read at my desk. >> i will read at my desk. >> at home and at school.
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>> on my beanbag your bed, by the fire or the pool. each book that i read, points smarts in my head. >> because brains grow more thoughts the more they are fed. >> the more they are fed. >> i take this out. >> i take this south to make reading my way. >> to make reading my way of feeding my brain. >> of reading my brain what it needs every day. >> what it needs every day. [applause]
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>> peter, the first book is called obama's the untold story of the african family. when we think about obama, a think of a multi-cultural man, one of mixed race heritage from a white mother and african father. and in some sense it could be the untold story of the american family but of an african family. why did you focus on this side of the family heritage and what is the significance? >> win the american people elect a president they elected leader of the free world you only have to see what is happening in cairo
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this week to see a good decision making now will affect the lives of 85 million egyptians. i sometimes think the american people did not fully appreciate of the president because he does have a very powerful and influential position over the rest of the world. not just the american people. that is the first thing they he is an important man to everybody. and he is fundamentally different from any previous presidents. he came up very quickly from relative obscurity and the democratic party lucky had a candidate peake says he made it to the white house and he is half black and half white and that made him very different.
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>> host: one of the things that seems very powerful and interesting about the obama is there is something about him that is offshore and when you look at previous presidents they are a recognizable american type the they may approve or disapprove. his maternal side group in kansas, seattle, hawaii. he then she comes up from the bohemia background but you focus on the father's side and trace it pretty far back. i want to read the names of the ancestors. you go back through 1624. why the ancient history? >> guest: you may have noticed all of


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